Tag Archives: gynecology

Best Books from 2023

Keeping it simple again this year with one post covering all genres: the 24 (or, actually 26) current-year releases that stood out the most for me. (No rankings; anything from my Best of First Half that didn’t make it through can be considered a runner-up, along with The Librarianist.)

 

Fiction

The New Life by Tom Crewe: Two 1890s English sex researchers (based on John Addington Symonds and Havelock Ellis) write a book called Sexual Inversion drawing on ancient Greek history and containing case studies of homosexual behaviour. Oscar Wilde’s trial puts everyone on edge; not long afterwards, their own book becomes the subject of an obscenity trial, and each man has to decide what he’s willing to give up in devotion to his principles. This is deeply, frankly erotic stuff, and, on the sentence level, just exquisite writing.

 

The Vaster Wilds by Lauren Groff: Groff’s fifth novel combines visceral detail and magisterial sweep as it chronicles a runaway Jamestown servant’s struggle to endure the winter of 1610. Flashbacks to traumatic events seep into her mind as she copes with the harsh reality of life in the wilderness. The style is archaic and postmodern all at once. Evocative and affecting – and as brutal as anything Cormac McCarthy wrote. A potent, timely fable as much as a historical novel.

 

Counting as one this thematic trio of women’s true crime pastiches; I liked the Makkai best.

Penance by Eliza Clark: A compelling account of teenage feuds and bullying that went too far and ended in murder. It’s a pretty gruesome crime, but memorable, not least because it coincided with the day of the Brexit vote. I loved Clark’s portrait of Crow-on-Sea, a down-at-heel seaside town near Scarborough, and the depth of character that comes through via interviews and documents. She also nails teenage dialogue and social media use, podcasts, true crime obsession and so on.

Bright Young Women by Jessica Knoll: An engrossing story of a Type A sorority president whose perfect life goes askew when a serial killer targets the house and kills two of her friends. She and the domestic partner of one of his previous victims are determined to see “the Defendant” brought to justice. 1970s Florida/Washington were interesting settings, and I liked the focus on the victims. The judge in the Defendant’s case lamented that such a bright young man would come to grief; think of the bright young women he extinguished instead.

I Have Some Questions for You by Rebecca Makkai: When an invitation comes from her boarding school alma mater, Granby, to teach a two-week course on podcasting, Bodie indulges her obsession with the 1995 murder of her former roommate. Makkai has taken her cues from the true crime genre and constructed a convincing mesh of evidence and theories. She so carefully crafts her pen portraits, and so intimately involves us in Bodie’s psyche, that it’s impossible not to get invested. This is timely, daring, intelligent, enthralling storytelling.

 

Sidle Creek by Jolene McIlwain: In this debut collection of 22 short stories, loosely linked by their location in the Appalachian hills in western Pennsylvania and a couple of recurring minor characters, McIlwain softens the harsh realities of addiction, poverty and violence with the tender bruises of infertility and lost love. Grief is a resonant theme in many of the stories, with pregnancy or infant loss a recurring element. At times harrowing, always clear-eyed, these stories are true to life and compassionate about human foibles and animal pain.

 

Mrs S by K Patrick: Patrick’s unnamed narrator is an early-twenties Australian butch lesbian who has come to England to be a matron at a girls’ boarding school. Mrs S is the headmaster’s wife, perhaps 20 years her senior. A heat wave gives a sultry atmosphere as hints of attraction between them give way to explicit scenes. Summer romances never last, but their intensity is legendary, and this feels like an instant standard. Not your average coming-of-age story, seduction narrative or cougar stereotype. It’s a new queer classic.

 

Romantic Comedy by Curtis Sittenfeld: Through her work as a writer for a sketch comedy show modelled on Saturday Night Live, Sally Milz meets Noah Brewster, a pop star with surfer-boy good looks. Plain Jane getting the hot guy – that never happens, right? In fact, Sally has a theory about this very dilemma… As always, Sittenfeld’s inhabiting of a first-person narrator is flawless, and Sally’s backstory and Covid-lockdown existence endeared her to me. Could this be called predictable? Well, what does one want from a romcom?

 

The House of Doors by Tan Twan Eng: In 1921, “Willie” Somerset Maugham and his secretary/lover, Gerald, stay with old friends Robert and Lesley Hamlyn in Penang, Malaysia. Willie’s marriage is floundering and he faces financial ruin. He needs a story that will sell and gets one when Lesley starts recounting the momentous events of 1910: volunteering at the party office of Dr Sun Yat Sen and trying to save her friend from a murder charge. Tan weaves it all into a Maugham-esque plot with sumptuous scene-setting and atmosphere.

 

Absolutely and Forever by Rose Tremain: At age 15, Marianne falls in love. She imagines her romance with Simon as a grand adventure (and escape from her parents’ ordinariness), but his post-school life in Paris doesn’t have room for her. Much changes over the next 15 years, but never her attachment to her first love. This has the chic, convincing 1960s setting of Tessa Hadley’s work, and Marianne’s droll narration is a delight. It put me through an emotional wringer – no cheap tear-jerker but a tender depiction of love in all its forms.

 

In Memoriam by Alice Winn: Heartstopper on the Western Front; swoon! Will Sidney Ellwood and Henry Gaunt both acknowledge that this is love and not just sex, as it is for so many teenage boys at their English boarding school? And will one or both survive the trenches of the First World War? Winn depicts the full horror of war, but in between there is banter, friendship and poetry. Some moments are downright jolly. This debut is obsessively researched, but Winn has a light touch with it. Engaging, thrilling, and, yes, romantic.

 

Nonfiction

All My Wild Mothers by Victoria Bennett: A lovely memoir about grief and gardening, caring for an ill child and a dying parent. The book is composed of dozens of brief autobiographical, present-tense essays, each titled after a wildflower with traditional healing properties. The format realistically presents bereavement and caring as ongoing, cyclical challenges rather than one-time events. Sitting somewhere between creative nonfiction and nature essays, it’s a beautiful read for any fan of women’s life writing.

 

Monsters by Claire Dederer: The question posed by this hybrid work of memoir and cultural criticism is “Are we still allowed to enjoy the art made by horrible people?” It begins, in the wake of #MeToo, by reassessing the work of film directors Roman Polanski and Woody Allen. The book is as compassionate as it is incisive. While there is plenty of outrage, there is also much nuance. Dederer’s prose is forthright and funny; lucid even when tackling thorny issues. Erudite, empathetic and engaging from start to finish.

 

Womb by Leah Hazard: A wide-ranging and accessible study of the uterus, this casts a feminist eye over history and future alike. Blending medical knowledge and cultural commentary, it cannot fail to have both personal and political significance for readers of any gender. The thematic structure of the chapters also functions as a roughly chronological tour of how life with a uterus might proceed: menstruation, conception, pregnancy, labour, caesarean section, ongoing health issues, menopause. Inclusive and respectful of diversity.

 

Sea Bean by Sally Huband: Stories of motherhood, the quest to find effective treatment in a patriarchal medical system, volunteer citizen science projects, and studying Shetland’s history and customs mingle in a fascinating way. Huband travels around the archipelago and further afield, finding vibrant beachcombing cultures. In many ways, this is about coming to terms with loss, and the author presents the facts about climate crisis with sombre determination. She writes with such poetic tenderness in this radiant debut memoir.

 

La Vie by John Lewis-Stempel: The author has written much about his Herefordshire haunts, but he’s now relocated permanently to southwest France (La Roche, in the Charente). He proudly calls himself a peasant farmer, growing what he can and bartering for much of the rest. La Vie chronicles a year in his quest to become self-sufficient. It opens one January and continues through the December, an occasional diary with recipes. It’s a peaceful, comforting read that’s attuned to the seasons and the land. Lewis-Stempel’s best book in an age.

 

All of Us Together in the End by Matthew Vollmer: In 2019, Vollmer’s mother died of complications of Alzheimer’s and Parkinson’s. Months later, his father reported blinking lights in the woods near the family cemetery. Although Vollmer had left the Seventh-Day Adventist Church in college, his religious upbringing influenced his investigation, which overlapped with COVID-19. Grief, mysticism, and acceptance of the unexplained are resonant themes. An unforgettable record of “a collision with the ineffable.”

 

Otherwise by Julie Marie Wade: Nine intricate autobiographical essays reflect on risk, bodily autonomy, and poetry versus prose. A series of meditations composed across Wade’s thirties arranges snapshots of her growing frustration with gendered stereotypes. In particular, she interrogates her rosy childhood notions of marriage. As she explored feminism and accepted her lesbian identity—though not before leaving a man at the altar—she found ways to be “a secular humanist by day and a hopeless romantic by night.” Superb.

 

Eggs in Purgatory by Genanne Walsh: This autobiographical essay tells the story of the last few months of her father’s life. Aged 89, he lived downstairs from Walsh and her wife in San Francisco. He was quite the character: idealist, stubborn, outspoken; a former Catholic priest. Although he had no terminal conditions, he was sick of old age and its indignities and ready to exit. The task of a memoir is to fully mine the personal details of a situation but make of it something universal, and that’s just what she does here. Stunning.

 

Poetry

More Sky by Joe Carrick-Varty: In this debut collection, the fact of his alcoholic father’s suicide is inescapable. The poet alternates between an intimate “you” address and third-person scenarios, auditioning coping mechanisms. His frame of reference is wide: football, rappers, Buddhist cosmology. The word “suicide” itself is repeated to the point where it becomes just a sibilant collection of syllables. The tone is often bitter, as is to be expected, but there is joy in the deft use of language.

 

Bright Fear by Mary Jean Chan: This follow-up to Flèche takes up many of the same foundational subjects: race, family, language and sexuality. But this time, the pandemic is the lens through which all is filtered. At a time when Asian heritage merited extra suspicion, English was both a means of frank expression and a source of ambivalence. At the centre of the book, “Ars Poetica,” a multi-part collage incorporating lines from other poets, forms a kind of autobiography in verse. Chan also questions the lines between genres. Excellent.

 

Lo by Melissa Crowe: This incandescent autobiographical collection delves into the reality of sexual abuse and growing up in rural poverty. Guns are insidious, used for hunting or mass shootings. Trauma lingers. “Maybe home is what gets on you and can’t / be shaken loose.” The collection is so carefully balanced in tone that it never feels bleak. In elegies and epithalamiums (poems celebrating marriage), Crowe honors family ties that bring solace. The collection has emotional range: sensuality, fear, and wonder at natural beauty.

 

A Whistling of Birds by Isobel Dixon: I was drawn to this for its acknowledged debt to D.H. Lawrence’s Birds, Beasts and Flowers. Snakes, bees, bats and foxes are some of the creatures that scamper through the text. There are poems for marine life, fruit and wildflowers. You get a sense of the seasons turning, and the natural wonders to prize from each. Dixon’s poetry is formal yet playful, the structures and line and stanza lengths varying. There are portraits and elegies. The book is in collaboration with Scottish artist Douglas Robertson. A real gem.

 

Standing in the Forest of Being Alive by Katie Farris: This debut collection addresses the symptoms and side effects of breast cancer treatment at age 36, but often in oblique or cheeky ways – it can be no mistake that “assistance” appears two lines before a mention of hemorrhoids, for instance, even though it closes an epithalamium distinguished by its gentle sibilance (Farris’s husband is Ukrainian American poet Ilya Kaminsky.) She crafts sensual love poems, and exhibits Japanese influences. (Discussed in my review essay for The Rumpus.)

 

The House of the Interpreter by Lisa Kelly: Kelly is half-Danish and has single-sided deafness, and her second collection engages with questions of split identity. One section ends with the Deaf community’s outrage that the Prime Minister’s Covid briefings were not translated into BSL. Bizarre but delightful is the sequence of alliteration-rich poems about fungi, followed by a miscellany of autobiographical poems full of references to colour, language, nature and travel.

 

Hard Drive by Paul Stephenson: This wry, wrenching debut collection is an extended elegy for his partner, Tod Hartman, an American anthropologist who died of heart failure at 38. There’s every style, tone and structure imaginable here. Stephenson riffs on his partner’s oft-misspelled name (German for death), and writes of discovery, autopsy, sadmin and rituals. In “The Only Book I Took” he opens up Tod’s copy of Joan Didion’s The Year of Magical Thinking – which came from Wonder Book, the bookstore chain I worked at in Maryland!

 


Okay, twist my arm … if I had to pick my overall books of the year, I’d concur with the Times in picking The New Life. In nonfiction: Monsters. In poetry: Standing in the Forest of Being Alive.

Have you read any of my favourites? What 2023 releases do I need to catch up on right away?

The Best Books from the First Half of 2023

Yes, it’s that time of year already! It remains to be seen how many of these will make it onto my overall best-of year list, but for now, these are my 20 highlights. Plus, I sneakily preview another great novel that won’t release until September. (For now I’m highlighting 2023 releases, whereas at the end of the year I divide my best-of lists into current year and backlist. I’ve read 86 current-year releases so far and am working on another 20, so I’m essentially designating a top 20% here.) I give review excerpts and link to the full text from this site or elsewhere. Pictured below are the books I read in print; all the others were e-copies.

 

Fiction

Shoot the Horses First by Leah Angstman: In 16 sumptuous historical stories, outsiders and pioneers face disability and prejudice with poise. The flash entries crystallize moments of realization, often about health. Longer pieces shine as their out-of-the-ordinary romances have space to develop. In the novella Casting Grand Titans, a botany professor in 1850s Iowa learns her salary is 6% of a male colleague’s. She strives for intellectual freedom, reporting a new-to-science species of moss, while working towards liberation for runaway slaves.

 

The House Is on Fire by Rachel Beanland: Moving at a propulsive pace, Beanland’s powerful second novel rotates through the perspectives of these main characters – two men and two women; two white people and two enslaved Black people – caught up in the Richmond Theater Fire of 1811 (one of the deadliest events in early U.S. history) and its aftermath. Painstakingly researched and full of historical detail and full-blooded characters, it dramatizes the range of responses to tragedy and how people rebuild their lives.

 

The New Life by Tom Crewe: Two 1890s English sex researchers (based on John Addington Symonds and Havelock Ellis) write a book called Sexual Inversion drawing on ancient Greek history and containing case studies of homosexual behaviour. Oscar Wilde’s trial puts everyone on edge; not long afterwards, their own book becomes the subject of an obscenity trial, and each man has to decide what he’s willing to give up in devotion to his principles. This is deeply, frankly erotic stuff, and, on the sentence level, just exquisite writing.

 

Daughters of Nantucket by Julie Gerstenblatt: (Yes, another historical fire novel, and I reviewed both for Shelf Awareness!) This engrossing debut explores the options for women in the mid-19th century. Metaphorical conflagrations blaze in the background in the days leading up to the great Nantucket fire of 1846: each of three female protagonists (a whaling captain’s wife, a museum curator, and a pregnant Black entrepreneur) holds a burning secret and longs for a more expansive, authentic life. Tense and sultry; for Sue Monk Kidd fans.

 

I Have Some Questions for You by Rebecca Makkai: When an invitation comes from her boarding school alma mater, Granby, to teach a two-week course on podcasting, Bodie indulges her obsession with the 1995 murder of her former roommate. Makkai has taken her cues from the true crime genre and constructed a convincing mesh of evidence and theories. She so carefully crafts her pen portraits, and so intimately involves us in Bodie’s psyche, that it’s impossible not to get invested. This is timely, daring, intelligent, enthralling storytelling.

                                  

Sidle Creek by Jolene McIlwain: In this debut collection of 22 short stories, loosely linked by their location in the Appalachian hills in western Pennsylvania and a couple of recurring minor characters, McIlwain softens the harsh realities of addiction, poverty and violence with the tender bruises of infertility and lost love. Grief is a resonant theme in many of the stories, with pregnancy or infant loss a recurring element. At times harrowing, always clear-eyed, these stories are true to life and compassionate about human foibles and animal pain.

 

Hello Beautiful by Ann Napolitano:  Oprah’s 100th book club pick. It’s a family story spanning three decades and focusing on the Padavanos, a working-class Italian American Chicago clan with four daughters. Julia meets melancholy basketball player William Waters while at Northwestern in the late 1970s. There is such warmth and intensity to the telling, and brave reckoning with bereavement, mental illness, prejudice and trauma. I love sister stories in general, and the subtle echoes of Leaves of Grass and Little Women add heft.

 

Romantic Comedy by Curtis Sittenfeld: Through her work as a writer for a sketch comedy show modelled on Saturday Night Live, Sally Milz meets Noah Brewster, a pop star with surfer-boy good looks. Plain Jane getting the hot guy – that never happens, right? In fact, Sally has a theory about this very dilemma… As always, Sittenfeld’s inhabiting of a first-person narrator is flawless, and Sally’s backstory and Covid-lockdown existence endeared her to me. Could this be called predictable? Well, what does one want from a romcom?

 

In Memoriam by Alice Winn: Heartstopper on the Western Front; swoon! Will Sidney Ellwood and Henry Gaunt both acknowledge that this is love and not just sex, as it is for so many teenage boys at their English boarding school? And will one or both survive the trenches of the First World War? Winn depicts the full horror of war, but in between there is banter, friendship and poetry. Some moments are downright jolly. This debut is obsessively researched, but Winn has a light touch with it. Engaging, thrilling, and, yes, romantic.

 

A bonus:

The Vaster Wilds by Lauren Groff (Riverhead/Hutchinson Heinemann, 12 September): Groff’s fifth novel combines visceral detail and magisterial sweep as it chronicles a runaway Jamestown servant’s struggle to endure the winter of 1610. Flashbacks to traumatic events seep into her mind as she copes with the harsh reality of life in the wilderness. The style is archaic and postmodern all at once. Evocative and affecting – and as brutal as anything Cormac McCarthy wrote. A potent, timely fable as much as a historical novel. (Review forthcoming for Shelf Awareness.)

 

Nonfiction

All My Wild Mothers by Victoria Bennett: A lovely memoir about grief and gardening, caring for an ill child and a dying parent. The book is composed of dozens of brief autobiographical, present-tense essays, each titled after a wildflower with traditional healing properties. The format realistically presents bereavement and caring as ongoing, cyclical challenges rather than one-time events. Sitting somewhere between creative nonfiction and nature essays, it’s a beautiful read for any fan of women’s life writing.

 

Monsters by Claire Dederer: The question posed by this hybrid work of memoir and cultural criticism is “Are we still allowed to enjoy the art made by horrible people?” It begins, in the wake of #MeToo, by reassessing the work of film directors Roman Polanski and Woody Allen. The book is as compassionate as it is incisive. While there is plenty of outrage, there is also much nuance. Dederer’s prose is forthright and droll; lucid even when tackling thorny issues. Erudite, empathetic and engaging from start to finish.

 

Womb by Leah Hazard: A wide-ranging and accessible study of the uterus, this casts a feminist eye over history and future alike. Blending medical knowledge and cultural commentary, it cannot fail to have both personal and political significance for readers of any gender. The thematic structure of the chapters also functions as a roughly chronological tour of how life with a uterus might proceed: menstruation, conception, pregnancy, labour, caesarean section, ongoing health issues, menopause. Inclusive and respectful of diversity.

 

Sea Bean by Sally Huband: Stories of motherhood, the quest to find effective treatment in a patriarchal medical system, volunteer citizen science projects, and studying Shetland’s history and customs mingle in a fascinating way. Huband travels around the archipelago and further afield, finding vibrant beachcombing cultures. In many ways, this is about coming to terms with loss, and the author presents the facts about climate crisis with sombre determination. She writes with such poetic tenderness in this radiant debut memoir.

 

Marry Me a Little by Robert Kirby: Hopping around in time, this graphic memoir tells the story of how the author and his partner John decided to get married in 2013. The blue and red color scheme is effective at evoking a polarized America and the ebb and flow of emotions, with blue for calm, happy scenes and concentrated red for confusion or anger. This is political, for sure, but it’s also personal, and it balances those two aims well by tracing the history of gay marriage in the USA and memorializing his own relationship.

 

All of Us Together in the End by Matthew Vollmer: In 2019, Vollmer’s mother died of complications of Alzheimer’s and Parkinson’s. Months later, his father reported blinking lights in the woods near the family cemetery. Although Vollmer had left the Seventh-Day Adventist Church in college, his religious upbringing influenced his investigation, which overlapped with COVID-19. Grief, mysticism, and acceptance of the unexplained are resonant themes. An unforgettable record of “a collision with the ineffable.”

 

Eggs in Purgatory by Genanne Walsh: This autobiographical essay tells the story of the last few months of her father’s life. Aged 89, he lived downstairs from Walsh and her wife in San Francisco. He was quite the character: idealist, stubborn, outspoken; a former Catholic priest. Although he had no terminal conditions, he was sick of old age and its indignities and ready to exit. The task of a memoir is to fully mine the personal details of a situation but make of it something universal, and that’s just what she does here. Stunning.

 

Poetry

More Sky by Joe Carrick-Varty: In this debut collection, the fact of his alcoholic father’s suicide is inescapable. The poet alternates between an intimate “you” address and third-person scenarios, auditioning coping mechanisms. His frame of reference is wide: football, rappers, Buddhist cosmology. The word “suicide” itself is repeated to the point where it becomes just a sibilant collection of syllables. The tone is often bitter, as is to be expected, but there is joy in the deft use of language.

 

Lo by Melissa Crowe: This incandescent autobiographical collection delves into the reality of sexual abuse and growing up in rural poverty. Guns are insidious, used for hunting or mass shootings. Trauma lingers. “Maybe home is what gets on you and can’t / be shaken loose.” The collection is so carefully balanced in tone that it never feels bleak. In elegies and epithalamiums (poems celebrating marriage), Crowe honors family ties that bring solace. The collection has emotional range: sensuality, fear, and wonder at natural beauty.

 

Standing in the Forest of Being Alive by Katie Farris: This debut collection addresses the symptoms and side effects of breast cancer treatment at age 36, but often in oblique or cheeky ways – it can be no mistake that “assistance” appears two lines before a mention of haemorrhoids, for instance, even though it closes an epithalamium distinguished by its gentle sibilance (Farris’s husband is Ukrainian American poet Ilya Kaminsky.) She crafts sensual love poems, and exhibits Japanese influences. (Review forthcoming at The Rumpus.)

 

The House of the Interpreter by Lisa Kelly: Kelly is half-Danish and has single-sided deafness, and her second collection engages with questions of split identity. One section ends with the Deaf community’s outrage that the Prime Minister’s Covid briefings were not translated into BSL. Bizarre but delightful is the sequence of alliteration-rich poems about fungi, followed by a miscellany of autobiographical poems full of references to colour, nature and travel.


What are some of the best books you’ve read so far this year?

What 2023 releases should I catch up on right away?

Womb: The Inside Story of Where We All Began by Leah Hazard

Back in 2019, I reviewed Hard Pushed, Leah Hazard’s memoir of being a midwife in a busy Glasgow hospital. Here she widens the view to create a wide-ranging and accessible study of the uterus. As magisterial in its field as Siddhartha Mukherjee’s The Emperor of All Maladies was for cancer, it might have shared that book’s ‘A Biography’ subtitle and casts a feminist eye over history and future alike. Blending medical knowledge and cultural commentary, it cannot fail to have both personal and political significance for readers of any gender.

The thematic structure of the chapters also functions as a roughly chronological tour of how life with a uterus might proceed: menstruation, conception, pregnancy, labour, caesarean section, ongoing health issues, menopause. With much of Hazard’s research taking place at the height of the pandemic, she had to conduct many of her interviews online. She consults mostly female experts and patients, meeting people with surprisingly different opinions. For instance, she encounters opposing views on menstruation from American professors: one who believes it is now optional, a handicap – for teenagers, especially – and that the body was never meant to endure 350–400 periods compared to the historical average of 100 (based on shorter lifespan plus more frequent pregnancy and breastfeeding); versus another who is concerned about the cognitive effects of constant hormonal intervention.

The book forcefully conveys how gynaecological wellness is threatened by a lack of knowledge, sexist stereotypes, and devaluation of certain wombs. Even today, little is known about the placenta, she reports, so research involves creating organoids from stem cells that act like it would. The use of emotionally damaging language like “irritable/hostile uterus,” “incompetent cervix” and “too posh to push” is a major problem. The sobering chapter on “Reprocide” elaborates on enduring threats to reproductive freedom, such as non-consensual sterilization of women in detention centres and the revoking of abortion rights. And even routine problems like endometriosis and fibroids disproportionately affect women of colour.

Hazard has taken pains to adopt an inclusive perspective, referring to “menstruators” or “people with a uterus” as often as to women and mentioning health concerns specific to transgender people. She is also careful to depict the sheer variety of experience: age at first menses, subjective reactions to labour or hysterectomy, severity of menopause symptoms, and so on. Where events have potentially traumatic effects, she presents alternatives, such as a “gentle” or “natural” Caesarean, which is less clinical and more empowering. The prose is pitched at a good level for laypeople: conversational, and never bombarding with information. That I have not had children myself was no obstruction to my enjoyment of the book. It is full of fascinating content that is relevant to all (as in the Harry and Chris solidarity-themed song “Womb with a View,” which has the repeated line “we’ve all been in a womb”).

Here are just some of the mind-blowing facts I learned:

  • Infant girls bleed in what as known as pseudomenses.
  • Research is underway to regularly test menstrual effluent for endometriosis, etc. and the uterine microbiome for signs of cancer.
  • The cervix can store sperm and release it later for optimal fertilization.
  • Caesarean section and induction with oxytocin now occur in one-third of pregnancies, despite the WHO recommendation of no more than 10% for the former and the danger of postpartum haemorrhage with the latter.
  • After childbirth, a discharge called lochia continues for 4–6 weeks.
  • There have been successful uterine transplants from living donors and cadavers.
  • Artificial wombs (“biobags”) have been used for other mammals and are in development; Hazard cautions about possible misogynistic exploitation.

With thanks to Virago Press for the free copy for review.

Hard Pushed: A Midwife’s Story by Leah Hazard

“For fans of Adam Kay’s This Is Going to Hurt and Christie Watson’s The Language of Kindness,” the blurb on my press release for Leah Hazard’s memoir opens. The publisher’s comparisons couldn’t be more perfect: Hard Pushed has the gynecological detail and edgy sense of humor of Kay’s book (“Another night, another vagina” is its first line, and the author has been known to introduce herself with “Midwife Hazard, at your cervix!”), and matches Watson’s with its empathetic picture of patients’ plights and medical professionals’ burnout.

Hazard alternates between anonymized case studies of patients she has treated and general thoughts on her chosen career (e.g. “Notes on Triage” and “Notes on Being from Somewhere Else”). Although all of the patients in her book are fictional composites, their circumstances are rendered so vividly that you quickly forget these particular characters never existed. Visceral details of sights, smells and feelings put you right there in the delivery room with Eleanor, one-half of a lesbian couple welcoming a child thanks to the now-everyday wonder of IVF; Hawa, a Somali woman whose pregnancy is complicated by the genital mutilation she underwent as a child; and Pei Hsuan, a Chinese teenager who was trafficked into sex work in Britain.

Sometimes we don’t learn the endings to these stories. Will 15-year-old Crystal have a healthy baby after she starts leaking fluid at 23 weeks? What will happen next for Pei Hsuan after her case is passed on to refugee services? Hazard deliberately leaves things uncertain to reflect the partial knowledge a hospital midwife often has of her patients: they’re taken off to surgery or discharged, and when they eventually come back to deliver someone else may be on duty. All she can do is to help each woman the best she can in the moment.

A number of these cases allow the author to comment on the range of modern opinions about pregnancy and childrearing, including some controversies. A pushy new grandmother tries to pressure her daughter into breastfeeding; a woman struggles with her mental health while on maternity leave; a rape victim is too far along to have a termination. At the other end of the spectrum, we meet a hippie couple in a birthing pool who prefer to speak of “surges” rather than contractions. Hazard rightly contends that it’s not her place to cast judgment on any of her patients’ decisions; her job is simply to deal with the situation at hand.

I especially liked reading about the habits that keep the author going through long overnight shifts, such as breaking the time up into 15-minute increments, each with its own assigned task. The excerpts from her official notes – in italics and full of shorthand and jargon – are a neat window into the science and reality of a midwife’s work, with a glossary at the end of the book ensuring that nothing is too technical for laypeople.

Hazard, an American, lives in Scotland and has a Glaswegian husband and two daughters. Her experience of being an NHS midwife has not always been ideal; there were even moments when she was ready to quit. Like Kay and Watson, she has found that the medical field can be unforgiving what with low pay, little recognition and hardly any time to wolf down your dinner during a break, let alone reflect on the life-and-death situations you’ve been a part of. Yet its rewards outweigh the downsides.

Hard Pushed has none of the sentimentality of Call the Midwife – a relief since I’m not one to gush over babies. Still, it’s a heartfelt read as well as a vivid and pacey one, and it’s alternately funny and sobering. If you like books that follow doctors and nurses down hospital hallways, you’ll love it. This was one of my most anticipated books of the first half of the year, and it lived up to my expectations. It’s also one of my top contenders for the 2020 Wellcome Book Prize so far.

 

A few favorite passages:

“So many things in midwifery are ‘wee’ [in Scotland, at least!] – a wee cut, a wee tear, a wee bleed, the latter used to describe anything from a trickle to a torrent. Euphemisms are one of our many small mercies: we learn early on to downplay and dissemble. The brutality of birth is often self-evident; there is little need to elaborate.”

“Whenever I dress a wound in this way, I remember that this is an act of loving validation; every wound tells a story, and every dressing is an acknowledgement of that story – the midwife’s way of saying, I hear you, and I believe you.”

“midwives do so much more than catch babies. We devise and implement plans of care; we connect, console, empathise and cheerlead; we prescribe; we do minor surgery. … We may never have met you until the day we ride into battle for you and your baby; … you may not even recognise the cavalry that’s been at your back until the drapes are down and the blood has dried beneath your feet.”

My rating:

 


Hard Pushed was published in the UK on May 2nd (just a few days before International Midwives’ Day) by Hutchinson. My thanks to the publisher for the free proof copy for review.